Ethics in Medicine : the Relationship Between Law and Medical Ethics:

After reading your post and many of the colleague in the class, most agree that is not professional to disregard the conversation that the family was having. Although the patient wishes were not to remain on life support and had a document to prove it he also fail to have a proxy to carry one his whishes. The Health Care Proxy is a simple document, legally valid in many states, which allows a person to name someone (an "agent") to make health care decisions their behalf if they are unable to make or communicate those decisions. (Society, 2015).

Though ethics committees have been helpful, scores of physician-patient disagreements end up in the U.S. court system with inconsistent results. The states adopted individual “statutes regulating DNR orders and their provisions vary in analysis throughout the U.S.” (Bishop, Brothers, Perry & Ahmad, 2010). One ethical dilemma that is constant in emergency rooms, the intensive care unit and terminally ill persons is a futility of treatment. In the case of CPR/DNR, New York State wanted to enact a law that describes the decisive responsibilities of the patient, and the family or surrogate, and physician. “In April 2003, the New-York Attorney General asserted that the DNR law would require a physician to obtain a consent of the patient’s health care surrogate before entering a DNR order, even when the physician

When a patient is unable to make decisions for himself or herself, their caregivers and those who know them are appointed to make the decisions based on what the patient would have wanted. This is called surrogate decision making. According to the article Terri Schiavo and End-of-Life Decisions “when surrogate decision makers and caregivers cannot agree upon what that choice would have been, they may turn to the courts to determine either what the now-incapacitated patient would have chosen or who is best suited to choose as the patient would have” (Mathes, 2005)

At the time of the Court’s ruling, eighteen states and Washington, D.C. had laws that allowed family members to withhold treatment from patients lacking the capacity to make medical decisions. The majority of these statutes required that the patient be terminally ill. As of June 1998, thirteen states require that the proxy have specific authorization and/or specific conditions be met in order to withhold artificial nutrition and hydration.

A patient barrier might include having limited knowledge surrounding life-support systems and treatment options, thereby hindering their ability to fully comprehend or demand certain interventions. Good counseling is therefore essential to overcoming this barrier in implementing the patient’s true and best wishes (Kroning, 2014, p. 222). Another barrier in implementing advance directives concerns the role and influence of family members and the patient. There may be discordance between the desires of the patient and family, which can result in serious debate and tension if not addressed and taken into consideration. Physicians still may have reservations, as certain demands made by the patient may raise ethical concerns in the future, if the provider feels the interventions being done are no longer medically appropriate.

This scenario presents various ethical issues that could be argued several ways from HIPPA violations to whether or not this patient has/had the cognitive ability to understand the execution of an advanced directive and Power of Attorney. Advance Directives are put in place for this very reason. It eliminates the need for family members to make a choice in the heat of the moment and also respects the wishes of the person whom it affects directly. Although Mr. E’s hypoxia could affect his ability to think clearly one cannot assume that he has an altered level of consciousness nor the inability to execute an advance

Every seriously ill patient and their family should have decided the following issues: proxy, resuscitation, hospitalization, and specific treatments. Every seriously ill person needs to have pointed out a person to speak on their behalf when they get too sick to do so. A “proxy” can be filled out at any hospital or nursing home granting “power of attorney” to a loved one to be able to make decisions. A person

In that situation a patient must be incapable of giving consent and no lawful surrogate is available to give the give the consent. Treatment can be initiated if there is danger of life or danger of a serious impairment of health. Immediate treatment can avert danger and save life. Treatment may be initiated in non-emergency situations if the patient is doubtfully competent and refuses treatment, the benefit of doubt goes to the patient unless the doctor seeks and obtain a court order. A health care provider should know that one individual does not have authority over another. A health care provider should look for the advanced directives such as a living will. A legal system like court order should be used to get a guardian who can give consent. In a nutshell the autonomy of individuals should have the protection of proper process and law in all health care settings. When there is any doubt a court may help. The court-appointed guardian will be the lawful surrogate who can consent to or refuse treatment in line with the best interests of the patient or the balanced choice

Medical ethics and legal issues have been a key topic in medical field for many years now. It is important for medical professionals to understand the importance of the way we care for patients, it is therefore important to be knowledgeable and aware of the medical ethics and legal issues that govern good patient care. Health care professionals must make decisions based on ethical and legal issues to performance their regular duties. However, Medical ethics is not only about avoiding harm to patients. It is rather a norms, values and principles (Ethical theories 2015). Therefore norms, values and principles are intended to govern medical ethical conduct. Ethics is defined as “a standard of behaviour and a concept of right and wrong beyond what the legal consideration is in any given situation”. In another words medical ethics is a discipline that used to handle moral problems coming out the care of patients. Law is another important discipline that often comes together with medical ethics. Law defined as a “rule of conduct or action prescribed or formally recognized as binding or enforced by a controlling authority”. Government imply law to keep the society running smoothly and to control behaviour that could threaten public safety. Medical professionals have to often prioritise these terms before making any clinical decision. The following findings will constructively emphasise on medical ethics, its

Since the patient has verbally communicated with her husband to make the decisions she should ever find herself in this situation. In this case, the New York’s Family Health Care Decisions making Act (FHCDA) and the New York Health Care Proxy Law will be used. The FHCDA, which is newly established, allows the family to make decisions for an incapacitated patient, regardless if the patient has either a signed advanced directive and the surrogate decision maker has direct knowledge of the patient's wishes or will act in the best interest of the patient (State of New York, Revised 2012). As an appointed guardian for Lydia, Mr. Bevin’s is allow make decisions for his

Apart from this, The Illinois General Assembly in 1991 passed the Illinois Health Care Surrogate Act which applies to all medical treatment decisions. “The Act provides standards for making decisions about treatment for individuals who lack decision-making capacity and who and have not executed a durable power of attorney for health care or a living will”( www.isms.org). In such cases the act allows family members, friends or guardians to act as a Healthcare surrogate. The health care surrogate in consultation with the attending physician can make medical treatment decisions on behalf of a minor or an adult patient who lacks decisional capacity. According to the law, the order of priority in determining the surrogate decision maker is the patient’s guardian, followed by the patient’s spouse, any adult child, parents, adult sibling, adult grandchild, and lastly a close friend.

If Lydia is found to be incompetent to make medical decisions; who should? The husband is her legal guardian so in this case, I think it is clear who has the legal right to act as Lydia’s proxy. According to research, in most states, unless the non incompetent patient previously designated a different decision maker, the spouse may act as the proxy. He/she together with the guidance of the physician may decide to withhold life-sustaining treatment (including in most states artificial nutrition and hydration) for a patient diagnosed to be in a terminal or irreversible condition. In all states, however, a patient’s legally recognized surrogate decision maker may direct that life-sustaining treatment not be provided if the surrogate can demonstrate by clear and convincing evidence that the patient would not want the treatment under present circumstances.

As an administrator I would need to take into consideration the patient’s autonomy, autonomy is recognizing an individual’s right to make his/her own decisions about what is best for them regarding their health care (Pozgar, 2012). The patient’s rights always should be considered before any decisions are made by any other family members. In this scenario it is clear that the patient is unable to make any decisions, the patient has suffered a serious brain damage, and although it is not complete brain death, we must determine how to proceed.

The case of Karen Ann Quinlan led to four basic approaches to this ethical problem; advance directives or other clear evidence of the patients wishes while competent, surrogate decision making (power of attorney), and action in the patients best interest. Each solution has deficiencies both in theory and practice, but there can be no debate that their application has changed the landscape of medical ethics.

The couple is asked to opt for surrogacy if the patient does not have a uterus, she has problems in uterus, she is unable to carry pregnancy safely, pregnancy is medically impossible, serious medical condition that could be exacerbated by pregnancy or cause significant risk to fetus, biological inability to conceive( homosexual couple). It is also an option if the couple has had multiple failures in IVF.